Improvement Stories

Ensuring Equal Healthcare for All: Chelsea Diabetes Disparities Program working to reduce differences in care

Why do disparities in diabetes care matter?

Robust scientific research has demonstrated that diabetes disproportionately affects minorities in the United States.  Nationwide, diabetes affects 11.2% of African Americans and 9% of Latinos, compared to 7.2% of whites.  Studies have also shown that Latinos are 33% less likely than whites to receive standard care for diabetes, including blood pressure and cholesterol control.  In a study at the MGH Chelsea Health Care Center, which serves the hospital’s largest Latino community, about one-third of Latino diabetics had not had their HbA1c level—a measure of blood sugar control—tested in the last nine months.  Moreover nearly twice as many Spanish-speaking Latinos (41%) had poor diabetes control, compared to English-speaking whites (23%). 

What is the MGH doing to reduce disparities in diabetes care?

The MGH Disparities Solutions Center and the MGH Chelsea Health Care Center have collaborated to develop the Chelsea Diabetes Management Program (CDMP) aimed at reducing disparities while improving care for all patients. Open to all diabetes patients at Chelsea HealthCare Center, but especially those in poor control, the CDMP has three main components, designed to improve patients’ awareness and understanding of how to control their diabetes:

  • Telephone outreach increase routine HbA1C screening
  • Individual patient coaching using a “culturally competent” approach
  • Bilingual educational sessions with groups of patients designed to provide important information and allow patients to share diabetes management strategies or in one-to-one sessions with a bilingual nurse
Where are we now?

Preliminary results show real progress in improving diabetes management among Chelsea HealthCare Center patients.  Since April 2006, 222 patients have been involved in the diabetes management program.  Among these patients, average HbA1c levels have decreased by 1.3 points (from 10.4 to 9.1), and 33% of patients who were characterized as having “poorly controlled” diabetes (i.e.—an HbA1c level greater than 8) became well controlled (HbA1c levels less than 8).  We hope this ongoing intervention will continue to help our patients gain control over a manageable chronic condition. 

 

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